Cardiovasc Ultrasound. 2026 Jul 23;24(1):24. doi: 10.1186/s12947-026-00385-3.
ABSTRACT
BACKGROUND: Arterial stiffness, as a biomarker of cardiovascular diseases, is most often described by a surrogate global stiffness index, pulse pressure wave velocity (PWV), a measure of the time for pressure pulses to transit to sensors normally placed on different arteries. However, local arterial elasticity also influences the transient response of an artery to an impulse of flow, as characterized by the local pulsatile flow velocity waveform. Such transient response to pulsatile flow has not previously been analyzed as an indicator of arterial stiffness and a biomarker of cardiovascular disease.
OBJECTIVES: The objectives of this exploratory study were to identify physical relationships between arteries' pulse flow velocity (PFV) transient response characteristics and the elasticity of central arteries, and to provide preliminary evidence of a match between measured arterial pulse flow response characteristics and those predicted by physical relationships.
METHOD: A transmission line model is applied to the analysis of transient blood flow velocity waveforms, a new analytic approach, offering a new measure of arterial elasticity, that of natural frequency, which is shown to be directly related to arterial stiffness. Specific flow velocity values, as measured at specific points on damped oscillation transient flow velocity waveforms, enable the determination of the natural frequency associated with the artery's transient response to an impulse of flow from the left ventricle.
RESULTS: The damped oscillation transient flow velocity waveforms, as measured by pulse Doppler ultrasound, is shown to match the damped oscillation flow velocity waveforms measured on the thoracic aorta and on the femoral artery. Such matching includes Bland-Altman analysis of waveform match using zero, one and two reflection sites. Also, the local stiffnesses of central arteries determined from the pulse Doppler ultrasound measurement of natural frequency are shown to match global stiffness reported for the same arteries using established PWV measurement approaches, providing an initial indicator of the validity of this new sonographic arterial elasticity measurement technique.
DISCUSSION AND CONCLUSIONS: This new arterial elasticity measurement technique, Doppler ultrasound measurement of vascular natural frequency, potentially offers advantages over established pulse pressure wave velocity measurement techniques as follows: a The measurement of elasticity at specific arterial locations; b The measurement of the elasticity of deeply set central arteries, and; c The potential for measuring central artery elasticity in clinical settings. This study is exploratory in that the application of pulse flow transient velocity waveform analysis to the determination of arterial elasticity is a novel departure from established pulse pressure wave analysis approaches. The study's preliminary findings, specifically the match between predicted transient flow velocity waveforms and those measured, and also the match between predicted PWVs to those measured using established pulse transit time techniques, are both sufficiently close that further independent verification and more extensive formal validation initiatives are indicated and justifiable.
PMID:42509555 | DOI:10.1186/s12947-026-00385-3